n A tax penalty on individuals for not buying qualifying coverage effective Jan. 1, 2014, that gradually increases over the next three years. In 2014 the penalty tax is limited to $95 or 1 percent of taxable income, whichever is greater, but by 2016 the tax grows to $695, or 2.5 percent of taxable income. In the years following, the penalty will increase by a cost-of-living adjustment;
n A payroll tax hike on higher-income taxpayers, lifting Medicare Part A’s tax bite to 2.35 percent from those workers’ paychecks;
n A 3.8 percent surtax on investment income for higher-income taxpayers;
n A tax increase that limits contributions to Flexible Savings Accounts to $2,500 and eliminates tax-free reimbursements for over-the-counter medicine for both FSAs and Health Savings Accounts;
n Limits on medical itemized deductions;
n An excise tax on insurers of employer-sponsored, high-end health plans, effective in 2018; this change places a punitive tax on those who have health coverage to help pay for those who do not.
n Annual fees on prescription drug manufacturing and health insurers; and,
n A 10 percent tax on indoor tanning services.
Expanding access to health care coverage for the uninsured has broad support and steps need to be taken to increase access to coverage, especially for individuals, and to increase transparency and competitiveness in the cost of health care services. But the new federal taxes, excises, penalties, mandates and fees in the Affordable Care Act come with tremendous economic costs. What’s more, the health care law won’t bend the spending curve on exploding health care costs or encourage medical innovation.
All things considered, just as Washington can’t tax our way to prosperity, the federal government can’t tax its way to universal health care coverage without inflicting more harm than good.